BY DR. EDWIN GRIMSLEY
Professor, Mercer University School of Medicine
Unless you have been tuned out since the Surgeon General’s report back in the 1960s, you know that cigarette smoking is the leading preventable cause of death in the United States.
Smoking cigarettes increases the risk of many types of cancer (especially lung cancer, but also colorectal cancer, head and neck cancers, including esophagus, kidney, liver, lower urinary tract, myeloid leukemia, pancreas, stomach, and possibly breast and skin cancer), as well as atherosclerotic cardiovascular disease and chronic obstructive pulmonary disease.
Currently, about 16 percent of adults in the U.S. smoke. Smoking cessation is beneficial, and there are many strategies used to assist with this worthwhile goal. One method that has gained popularity is the use of electronic cigarettes (e-cigarettes), also known as “vaping.”
If used as a complete substitute for regular cigarettes and other smoked tobacco products, e-cigarettes have the potential to benefit adult smokers who are not pregnant. However, more trials are needed to assess the exact role of e-cigarettes in smoking cessation.
E-cigarettes come in many shapes and sizes. Most have a battery, a heating element and a place to hold a liquid. The element heats and aerosolizes the liquid, creating a vapor that simulates tobacco smoke. The liquid usually contains nicotine, which can help lessen the craving for cigarettes. The vapor can also contain particles, flavorings, volatile organic compounds, potentially cancer-causing chemicals and heavy metals such as nickel, tin and lead.
E-cigarettes do not expose the user to many of the 7,000 toxic ingredients found in cigarette smoke that cause many of the tobacco-related diseases. At least 70 of those ingredients can cause cancer. While inhaling e-cigarette vapor may be less harmful than inhaling cigarette smoke, there are no long-term studies that prove this.
Nicotine is highly addictive and is toxic to developing fetuses. It can also harm adolescent brain development. For these reasons, pregnant women and young people should not use e-cigarettes.
Nicotine can increase heart rate and blood pressure, though studies that evaluated nicotine patches or other nicotine replacement devices have not shown an increase in cardiovascular risks. The amount of nicotine delivered, and the level of nicotine in the blood, varies depending on nicotine amount in the e-cigarette liquid, puffing intensity, device type and vaping technique.
E-cigarettes can cause unintended injuries. Defective e-cigarette batteries have caused fires and explosions, some of which have resulted in serious injuries.
Between January 2009 and December 2016, 195 separate incidents of explosion and fire involving an electronic cigarette were reported by U.S. media. These incidents resulted in 133 acute injuries. Most explosions occurred while the e-cigarette batteries were being charged.
In a recent study, the Centers for Disease Control and Prevention (CDC) found that many adults use e-cigarettes to quit smoking. However, most adult e-cigarette users do not stop smoking cigarettes and instead continue to use both products (known as dual use).
Among current e-cigarette users 18 to 24 years old, a whopping 40 percent have never been regular cigarette smokers. This indicates that this group uses e-cigarettes recreationally. Also, an unfortunate statistic is that 11.3 percent of high school students now use e-cigarettes recreationally.
Though e-cigarettes may have a role in smoking cessation, there are certainly safer, more proven effective methods available, such as other nicotine replacement products and prescription medications.
Smoking cessation is the easiest thing you can do to improve your overall health and well-being. People who stop smoking greatly reduce their risk for disease and early death. While smoking cessation is of greatest benefit when done at a young age, there are benefits to stopping smoking at any age.
Edwin W. Grimsley, M.D., MACP
Professor of Medicine
Mercer University School of Medicine